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Background: The negative impact of COVID-19 pandemic on healthcare service utilization has been reported in several countries. In Gabon, data on the preparedness for future pandemic are lacking. The aim of the present study was to assess the trends of hospital attendance, malaria and self-medication prevalences as well as ITN use before and during Covid-19 first epidemic waves in a paediatric wards of a sentinel site for malaria surveillance, in Libreville, Gabon. Methods: This was a retrospective descriptive and hospital-based survey which was conducted at the Regional Hospital of Melen Estuaire (RHME). Census of files of patients below 18 years of age attending for fever management with a result of malaria biological diagnosis from January 2018 to December 2022 was conducted. Comparison of the prevalence of microscopic malaria, ITN use, self-medication and the fever duration prior the screening before and after year 2020 was performed using bivariate and multivariate analysis. Results: Overall, 14428 febrile participants were screened for malaria. A 15% increase in the number of febrile patients was observed between 2019 and 2020 while this rate was above 100% in 2021 and 2022. The frequency of self-medication significantly doubled in 2020 and 2021 compared to the pre-COVID-19 period (p < 0.01). Previous self-medication was more common during the COVID-19 period compared to the COVID-19 one (aOR = 2.15 [1.91–2.42]) (p < 0.01). Among the 7259 (51.2%) patients screened after 3 days of fever onset, self-anti-malarial treatment was reported for 17.5% of them in 2019 and for more than 30% of them from 2020: 33.3% in 2020, 35.0% in 2021 and 32.3% in 2022 (p < 0.01). The median of fever duration was significantly higher in the group of participants with a previous self-medication (p < 0.01). Positive blood smears frequency was higher in the COVID-19 period (35.6%; n = 3876/10868) compared to the pre-COVID-19 period (23.6%) (OR = 1.79[1.59–2.02], (p < 0.01). Conclusion: Malaria prevalence and care-seeking behaviours for fever management in children significantly changed during the COVID-19 epidemic phase and subsequent years in the main malaria sentinel surveillance site of Gabon. [ABSTRACT FROM AUTHOR]

Malaria is a significant public health challenge in Gabon, with high prevalence rates in rural and semi-urban areas. This study investigated Plasmodium infection prevalence among outpatients at a medical laboratory in Franceville, Gabon, in 2020. Data from 500 patients were analyzed, revealing an overall infection rate of 33.2% and the presence of four Plasmodium species: P. falciparum, P. malariae, P. ovale, and possibly P. vivax for the first time in Gabon. Co-infections were common, with P. falciparum and P. ovale spp. being the most prevalent at 23.5%. Asymptomatic infections accounted for 81.3% of cases, while symptomatic infections were 18.7%. P. falciparum was associated with symptomatic cases, while non-falciparum species were linked to asymptomatic infections. The findings suggest Franceville has perennial malaria transmission, highlighting the role of Plasmodium species diversity in disease severity and clinical presentation, including the first report of P. vivax infection in the Gabonese population. [ABSTRACT FROM AUTHOR]

Antibody glycosylation patterns can affect antibody functionality and thereby contribute to protection against invading pathogens. During pregnancy, maternal antibodies can be transferred through the placenta and contribute to modulating both the mother's and her child's immune responses. Although several studies of IgG glycosylation during pregnancy have been carried out, very few cohorts studied were from sub-Saharan Africa, where exposure to microorganisms and parasites is high. In Lambaréné, Gabon, 106 pregnant women in their third trimester were enrolled into this study. At enrolment, urine, stool, and blood samples were collected from the mothers to assess Schistosoma haematobium (S. haematobium), Plasmodium falciparum (P. falciparum) and other parasite infections. During delivery, cord blood samples were collected. The children were followed, and blood samples were collected at 9 and 12 months of age. IgG Fc glycosylation was measured by liquid chromatography-mass spectrometry, determining fucosylation, galactosylation, sialylation, bisection, and sialylation per galactose (SA/gal). Among the 106 pregnant women, 33 (31%) were infected by at least one parasite. The antibody glycosylation patterns in maternal and cord blood showed distinct profiles when compared to that of infants at 9 and 12 months. IgG galactosylation was higher in maternal/cord blood, while fucosylated IgG was higher in children up to 1 year of age. Maternal parasitic infection was associated with lower IgG2 and IgG3/IgG4 galactosylation in cord blood and lower IgG3/IgG4 galactosylation in children. When maternal IgG galactosylation and, consequently, cord blood were categorized as high, children at 9 and 12 months of age showed higher IgG galactosylation compared to children of mothers with low IgG galactosylation. As IgG Fc galactosylation can have functional consequences, it might provide valuable information for developing effective preventive and treatment strategies for vulnerable populations. [ABSTRACT FROM AUTHOR]

Anaplasma spp. is an emerging human zoonosis, usually transmitted by tick bites. Human-to-human transmission is rare, and transplacental transmission is even less common. No cases of transplacental transmission have been previously reported. We report the cases of patients who were followed up for febrile syndrome diagnosed with maternal-fetal infection and treated with antibiotic therapy and hemodynamic correction. Investigation of the etiology revealed Anaplasma spp. in a neonatal infection. These cases prove that transplacental transmission of Anaplasma spp. is possible and that surveillance is important. [ABSTRACT FROM AUTHOR]

Background and Aim: Rodents are carriers or reservoirs of various bacteria, protozoa, viruses, and ectoparasites. Given the proximity of various rodent species and humans, there is a potential for the transmission of pathogens. Data on ecto- and endo-parasite prevalence in rodent populations in Gabon are limited. To fill this gap, we conducted a study in Libreville to investigate the occurrence of ecto- and endo-parasites in rodents. Materials and Methods: We captured and euthanized 68 rodents belonging to the genus Praomys and examined their ecto- and endo-parasite fauna, dissected their gastrointestinal tract for helminths, and prepared blood smears to examine blood-borne pathogens. Results: Our analyses identified three pathogen taxa: helminths (Protospirura spp., Trichuris spp., and Taenia spp.), protozoa (Babesia spp.), bacteria (Anaplasma spp.), and arthropods (Laelaps and Haemaphysalis). Overall, 91.2% of the rodents were infected with at least one pathogen and ectoparasite, with helminth occurrence rate of 63.2% and ectoparasite occurrence at 44.1%. Protozoan infections (Babesia spp.) were found in 10.3% of the rodents, whereas bacteria (Anaplasma spp.) had an occurrence rate of 39.7%. Conclusion: Native rodents in Libreville harbor various infectious agents, ecto- and endo-parasites. These findings highlight the potential health risks associated with Praomys rodents for the transmission of various diseases to human population in Gabon and emphasize the need for investigation of rodents for their role as disease carriers. [ABSTRACT FROM AUTHOR]

Background: Insecticides are a crucial component of vector control. However, resistance constitute a threat on their efficacy and the gains obtained over the years through malaria vector control. In Gabon, little data on phenotypic insecticide resistance in Anopheles vectors are published, compromising the rational implementation of resistance management strategies. We assessed the susceptibility to pyrethroids, carbamates and organophosphates of Anopheles gambiae sensu lato (s.l.) and discuss the mechanisms involved in the pyrethroid resistance-phenotype. Methods: A. gambiae s.l. larvae were collected from breeding sites in Lambaréné. Emerging adults were used in WHO tube assays at an insecticide concentration that defines resistance (diagnostic concentration). Subsequently, deltamethrin and permethrin were used at 5x and 10x diagnostic concentrations and after preexposure with the cytochrome p450 (and glutathione S-transferase) inhibitor piperonyl butoxide (PBO). A subset of mosquitoes was typed by molecular methods and screened using Taqman assays for mutations conferring target site resistance at the Voltage-gated sodium channel 1014 (Vgsc-1014) locus and the acetylcholinesterase (Ace-1) gene. Results: All mosquitoes were A. gambiae sensu stricto (s.s.) and resistant to permethrin, deltamethrin and alphacypermethrin (mortality less than 98%). However, mosquitoes were susceptible to malathion but resistant to bendiocarb. The level of resistance was high for permethrin and at least moderate for deltamethrin. Pre-exposure to PBO significantly increased the mortality of resistant mosquitoes (P < 0.0001). They became fully susceptible to deltamethrin and permethrin-induced mortality increased 4-fold. The G119S Ace-1 resistance allele, which confers resistance to both organophosphates and carbamates, was not present. All sampled mosquitoes were either homozygous for the Vgsc-L1014F or heterozygous for Vgsc-L1014F/L1014S, a marker for resistance to pyrethroids and organochlorides. Conclusion: These findings demonstrate a role of cytochrome P450 monooxygenases in the pyrethroid-resistance of A. gambiae s.s. from Lambaréné. Combining PBO with pyrethroids, as done in second generation bednets, may be used to revert resistance. In addition, malathion could also be used in combination with pyrethroids-based methods for resistance management. [ABSTRACT FROM AUTHOR]

Background: High-risk genotypes of Human Papillomavirus are responsible for 90% of cases of cervical cancer worldwide. Inflammation of squamous cells is mainly linked to HPV. In Gabon, HPV is endemic and circulates among the female population. The study aimed to determine the prevalence of HR-HPV genotypes and to investigate the correlation between squamous cell inflammation and HPV viral load in infected women in Gabon. Methods: The cross-sectional study was conducted at Libreville University Hospital Center (UHC) and National Public Health Laboratory from March to May 2024 among 399 women. Two cervical smears were taken. Genotype detection was carried out by multiplex fluorescence real-time PCR in the NPHL virology unit. Cytology was carried out in UHC's anatomic-pathology laboratory. Data were analyzed by SPSS software. Graphs were plotted using Microsoft Excel 2016. Results: The prevalence of Human Papillomavirus was 26.1% (95% CI: 22-30.6). The prevalence of HR-HPV genotypes was 24.8%. The most common HR-HPV genotypes were HPV-16/52/18/35/56/58/53/68. The rate of multiple HPV infections was 29.8% and 95.2% for the HR-HPV infection rate. Viral load was significantly correlated with squamous cell inflammation (r = 0.977 and P = 0.001). Conclusion: HR-HPV infection remains a concern in women, however early screening is necessary for optimal monitoring and management. HR-HPV viral load is a predictive marker of squamous cell inflammation. [ABSTRACT FROM AUTHOR]

Seroconversion surveys of anti-SARS-CoV-2 antibodies provide accurate estimates of the prevalence of SARS-CoV-2 infections. This nationwide population-based cross-sectional serosurvey aimed to evaluate the prevalence of SARS-CoV-2 antibodies among residents in Gabon and compare the estimated cumulative number of COVID-19 cases with the officially registered number of laboratory-confirmed cases up to December 2021. Households in each province were randomly selected. Twenty-eight localities, including sixteen urban and twelve rural, were randomly selected for the study. Whole blood samples were collected in dry tubes from all study participants nationwide within 15 days. Serum samples were used to measure SARS-CoV-2-specific ELISA titers. Overall, data from 1672 households were analyzed. Out of the 3659 participants, 3175 were found to be positive for SARS-CoV-2 antibodies, resulting in a crude seroprevalence of 86.77%. Stratification of study participants by age group showed the highest seroprevalences in the 20–29 and 40–49 age groups with 91.78% (95% CI: 89.5–93.6) and 91.42% (95% CI: 88.7–93.5), respectively. Nyanga province had the lowest prevalence (72.8%), and Estuaire and Ogooué-Lolo provinces had the highest prevalence (90 and 92%). Our results suggest a high transmission rate in the Gabonese population 21 months after the first SARS-CoV-2 case in the country. This high seroprevalence estimate could indicate that the population may not have adequately implemented or appropriately adhered to the applied infection control measures. [ABSTRACT FROM AUTHOR]

L'objectif de ce travail est d'analyser les liens qui existent entre image du corps, estime de soi et honte corporelle (variables dépendantes) chez les patients atteints par le VIH, en fonction de l'âge, du sexe, du niveau d'étude, du statut sérologique et de l'année de dépistage. Nous voulions voir aussi comment ces variables indépendantes (genre et âge) influent sur l'estime de soi, l'image du corps et la honte corporelle. Les participants étaient 158 patients VIH (hommes et femmes) qui ont rempli une batterie de mesures d'autoévaluation : échelle d'estime de soi de Rosenberg (1965), échelle de l'image corporelle (QIC) de Bruchon-Schweitzer (1990) et la sous-échelle de honte corporelle de l'échelle d'expérience de la honte (ESS) d'Andrews et al. (2002). La première hypothèse qui teste le lien entre estime de soi, image du corps et honte corporelle et les variables sociodémographiques (âge, sexe, niveau d'étude, statut sérologique et année de dépistage) montrent un lien significatif chez les patients VIH gabonais. La seconde hypothèse qui évalue l'influence de l'âge et le genre sur toutes nos variables dépendantes (estime de soi, image du corps et honte corporelle) montre que les femmes n'expriment pas davantage une insatisfaction corporelle et de la honte par rapport à leur corps et que leur niveau d'estime de soi n'est pas moins élevé que celui des hommes. Pour finir, les résultats montrent qu'en s'appuyant sur la comparaison intergroupes, l'estime de soi est plus faible chez les jeunes dans certains groupes d'âge. Il existe des liens significatifs entre estime de soi, image du corps et honte corporelle. Aussi, l'estime de soi est plus faible chez les jeunes patients VIH. Pour les cliniciens engagés dans la prise en charge des patients VIH, la connaissance du niveau d'estime de soi, d'insatisfaction corporelle et de honte corporelle permettrait d'élaborer des prises en charge adaptées et des objectifs d'interventions thérapeutiques appropriés (groupe thérapeutique, groupe ponctuel pour accroître efficacité personnelle). The study proposes the analysis of the relationship between body image, self-esteem and body shame (dependent variables) in HIV patients according to their age, gender, level of education, HIV status and year of their HIV screening. We also wanted to see how independent variables (gender and age) affect self-esteem, body image and body shame. Participants included 158 HIV patients (men and women) who completed a battery of self-report measures: the Rosenberg Self-Esteem Scale (1965), the Bruchon-Schweitzer Body Image Scale (BIS) (1990), and the body shame subscale from the Shame Experience Scale (ESS) by Andrews et al. (2002). The first hypothesis, which tests the link between self-esteem, body image and body shame and the sociodemographic variables (age, gender, level of education, HIV status and year of screening), showed a significant relationship among Gabonese HIV patients. The second hypothesis, which evaluates the influence of age and gender on all our dependent variables (self-esteem, body image and body shame), indicated that women are no more likely to express more body dissatisfaction and shame about their bodies and their level of self-esteem is no lower than that of men. Finally, an intergroup comparison demonstrated that self-esteem is lower among youth in certain age groups. There are significant links between self-esteem, body image and body shame with a lower level of self-esteem in young HIV patients. For clinicians involved in the management of HIV patients, knowledge of the level of self-esteem, body dissatisfaction and body shame would allow for the development of appropriate care and therapeutic intervention goals (therapeutic group, self-efficacy group). [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) infection is one of the major public health problems worldwide. In pregnant women, there is a risk of mother-to-child transmission (vertical transmission) of the infection. The contaminated newborn will most often remain a chronic carrier. Gabon is part of the highly endemic area for hepatitis B. This study aims to determine the prevalence of hepatitis B in pregnant women at the Estuaire Regional Hospital of Melen, Libreville, Gabon. Material and methods: The study was carried out at the Laboratory of the Center Hospitalier Régionale Estuaire Melen (CHREM), over a period of 5 years, from January 2018 to December 2022. It was a retrospective and prospective study ranging from January 2018 to December 2022. For the prospective study, the data was collected in the CHREM Laboratory library, by using registers and filing cabinets. For the prospective study, blood samples were taken and analyzed using Abbott Determine® HBsAg kits and the BioMérieux mini Vidas system. The variables studied were age, HBs status, profession, level of study, and residence. The data collected was entered into an Excel file (Microsoft Office 2016) and analyzed using XLSTAT 2016.4.01 and Epi Info™ 7.2.5 software and expressed as means and percentages. Results: A total of 1615 pregnant women seen in the CHREM laboratory department were included in the study. Of which, 315 were diagnosed as HBsAg carriers, representing a prevalence of 8.36%. Depending on the year, the highest prevalence was observed in 2019 with 20 positive cases out of 267 women screened, i.e., 9.38%. Depending on the districts, the highest prevalence was found in the Essassa and Plein Ciel districts with 16.43% and 18.18%, respectively. According to the age groups, the highest prevalence was observed in the age group 26–30 with 10.16% (p = 0.075) out of 492 patients screened. Depending on the profession, the prevalence was higher among female students with 21.97% (p = 0.020). According to marital status, unmarried had the highest prevalence with 8.8% (p = 0.064). And according to nationality, women of Gabonese nationality had a higher prevalence with 9.52%. Conclusion: Antenatal transmission of HBV is high in Libreville. The inaccessibility of antiviral therapy for viral hepatitis B makes the immunization of mothers and children a priority in Gabon. [ABSTRACT FROM AUTHOR]

A human hookworm vaccine is being developed to protect children against iron deficiency and anaemia associated with chronic infection with hookworms. Necator americanus aspartic protease-1 (Na -APR-1) and N americanus glutathione S-transferase-1 (Na -GST-1) are components of the blood digestion pathway critical to hookworm survival in the host. Recombinant Na -GST-1 and catalytically inactive Na -APR-1 (Na -APR-1[M74]) adsorbed to Alhydrogel were safe and immunogenic when delivered separately or co-administered to adults in phase 1 trials in non-endemic and endemic areas. We aimed to investigate the safety and immunogenicity of these antigens in healthy children in a hookworm-endemic area. This was a randomised, controlled, observer-blind, phase 1, dose-escalation trial, conducted in a clinical research centre, in 60 children aged six to ten years in Lambaréné, a hookworm-endemic region of Gabon. Healthy children (determined by clinical examination and safety laboratory testing) were randomised 4:1 to receive co-administered Na -GST-1 on Alhydrogel plus Na -APR-1(M74) on Alhydrogel and glucopyranosyl lipid A in aqueous formulation (GLA-AF), or co-administered ENGERIX-B hepatitis B vaccine (HBV) and saline placebo, injected into the deltoid of each arm. Allocation to vaccine groups was observer-masked. In each vaccine group, children were randomised 1:1 to receive intramuscular injections into each deltoid on two vaccine schedules, one at months 0, 2, and 4 or at months 0, 2, and 6. 10 μg, 30 μg, and 100 μg of each antigen were administered in the first, second, and third cohorts, respectively. The intention-to-treat population was used for safety analyses; while for immunogenicity analyses, the per-protocol population was used (children who received all scheduled vaccinations). The primary outcome was to evaluate the vaccines' safety and reactogenicity in healthy children aged between six and ten years. The secondary outcome was to measure antigen-specific serum IgG antibody levels at pre-vaccination and post-vaccination timepoints by qualified ELISAs. The trial is registered with ClinicalTrials.gov , NCT02839161 , and is completed. Between Jan 23 and Oct 3, 2017, 137 children were screened, of whom 76 were eligible for this trial. 60 children were recruited, and allocated to either 10 μg of the co-administered antigens (n=8 for each injection schedule), 30 μg (n=8 for each schedule), 100 μg (n=8 for each schedule), or HBV and placebo (n=6 for each schedule) in three sequential cohorts. Co-administration of the vaccines was well tolerated; the most frequent solicited adverse events were mild-to-moderate injection-site pain, observed in up to 12 (75%) of 16 participants per vaccine group, and mild headache (12 [25%] of 48) and fever (11 [23%] of 48). No vaccine-related serious adverse events were observed. Significant anti- Na -APR-1(M74) and anti- Na -GST-1 IgG levels were induced in a dose-dependent manner, with peaks seen 14 days after the third vaccinations, regardless of dose (for Na -APR-1[M74], geometric mean levels [GML]=2295·97 arbitrary units [AU] and 726·89 AU, while for Na -GST-1, GMLs=331·2 AU and 21·4 AU for the month 0, 2, and 6 and month 0, 2, and 4 schedules, respectively). The month 0, 2, and 6 schedule induced significantly higher IgG responses to both antigens (p=0·01 and p=0·04 for Na -APR-1[M74] and Na -GST-1, respectively). Co-administration of recombinant Na -APR-1(M74) and Na -GST-1 to school-aged Gabonese children was well tolerated and induced significant IgG responses. These results justify further evaluation of this antigen combination in proof-of-concept controlled-infection and efficacy studies in hookworm-endemic areas. European Union Seventh Framework Programme. [ABSTRACT FROM AUTHOR]

During the Early Cretaceous, massive evaporite accumulations formed in the opening South Atlantic. However, the depositional model of these salts is still poorly constrained at the scale of the West African margin. The present study focuses along the proximal domain of the south Gabon‐Congo‐Cabinda margin and is based on (i) log interpretations of 246 wells crossing undeformed to weakly deformed evaporite intervals and (ii) a structural characterization of the basement. The evaporites show 11 regional evaporite depositional cycles (CI–CXI) bounded by meter‐thick shale beds. The cycles display alternating meter‐scale carnallite‐halite beds that can be correlated over several hundred kilometres, and CVI, CVII, CVIIIa and CX culminate in localized tachyhydrite accumulations. Cross section correlations and isopach maps help to understand the palaeogeographical evolution of each cycle and depositional environments that evolved from relatively deep at the base of cycles, to very shallow at their top. CI formed a mosaic of halite‐prone depocenters deposited in pre‐salt topographic relief. CII and CIII were deposited uniformly over a flattened basin in a highly extended brine pond. From CIV to CVIIIa, the stratigraphic architecture of the salts was shaped by freshwater inflow sourced from the north and possible basement movements. This setting, together with an increased confinement of the proximal domain from the distal one with basin drawdown, favoured the development of depocenters with perennial subaqueous conditions and extreme salinities, in which more than 70 m of tachyhydrite accumulation could locally be preserved. From CVIIIb to CXI, the basin returned to a flat depositional setting without well‐developed depocenters and with increasing subsidence westwards. Marine influx increased starting from CX, allowing the deposition of sulphate beds. The salt section is capped by anhydrite deposits interbedded with clastic and dolomite, before the final marine invasion of the basin. For the first time, this study provides a large‐scale depositional tectonostratigraphic setting of the Aptian salts in the proximal domain of the West African margin. The results are of interest for K‐Mg salts exploration resources in the Aptian and pave the way for further investigation of the salt depositional environment in the distal domain of the margin. [ABSTRACT FROM AUTHOR]

The aim of this study, which is one of the few studies undertaken in this region in Gabon, was to determine the radioactivity levels in various lakes and rivers in the Mounana region by measuring the activity concentrations of alpha- and beta-emitter radionuclides. For this purpose, gross alpha (α)-beta (β) counting was carried out using a Canberra Tenelec Gas flow counter detector. From the samples collected, about 18% and 36% contained higher gross α -activity and higher gross β -activity compared to the World Health Organization (WHO) guideline limits of 0.5 Bq l−1and 1 Bq l−1, respectively. It was also observed that 18% of the samples collected contained both gross α-and β -activities higher than the WHO guideline limits. The gross α -activity concentrations measured ranged between 0.026 ± 0.003 Bq l−1 and 1.602 ± 0.012 Bq l−1 while the gross β -activity concentrations measured ranged between 0.15 ± 0.01 Bq l−1 and 3.00 ± 0.04 Bq l−1. Given that these waters are used by the population living in Mounana for the domestic purposes, a few may be exposed to the low levels of internal radiation but below the permissible levels of 1 mSv per annum. [ABSTRACT FROM AUTHOR]

In this third contribution to the study of the cults of the hallucinogenic plant of iboga of Equatorial Africa, the themes concerning the mythical origins of the plant and of Bwiti--the religious cult that uses iboga as a visionary agent--are presented and analysed. Distinction is made between the mythological themes of the traditional cults, in particular those of the Mitsogho of central-southern Gabon, and those of the cults syncretic with Christianity, as developed by the Fang ethnic group of northern Gabon and Equatorial Guinea. In the Fang Bwiti the mythical origins of the cult are described in a tale, the "story of Banzioku", of which there are numerous versions handed down by different branches. A comparative study of 26 versions of the "story of Banzioku" is undertaken. One of the stories is previously unpublished, collected by the author in 2022 from a community of the Ndea Kanga branch. [ABSTRACT FROM AUTHOR]

Hepatitis B virus (HBV) infection leads to around 800,000 deaths yearly and is considered to be a major public health problem worldwide. However, HBV origins remain poorly understood. Here, we looked for bat HBV (BtHBV) in different bat species in Gabon to investigate the role of these animals as carriers of ancestral hepadnaviruses because these viruses are much more diverse in bats than in other host species. DNA was extracted from 859 bat livers belonging to 11 species collected in caves and villages in the southeast of Gabon and analyzed using PCRs targeting the surface gene. Positive samples were sequenced using the Sanger method. BtHBV DNA was detected in 64 (7.4%) individuals belonging to eight species mainly collected in caves. Thirty-six (36) sequences among the 37 obtained after sequencing were phylogenetically close to the RBHBV strain recently isolated in Gabonese bats, while the remaining sequence was close to a rodent HBV strain isolated in America. The generalized linear mixed model showed that the variable species best explained the occurrence of BtHBV infection in bats. The discovery of a BtHBV strain homologous to a rodent strain in bats raises the possibility that these animals may be carriers of ancestral hepadnaviruses. [ABSTRACT FROM AUTHOR]

Background and Aim: Cryptosporidium spp. members of the phylum Apicomplexa are obligate protozoan parasites capable of infecting various vertebrate hosts, including rodents and chickens. Infection caused by these parasites may lead to zoonotic diseases in humans. The aim of this study was to estimate the prevalence of Cryptosporidium spp. in rodents and domestic chickens sampled in Franceville, Gabon. Materials and Methods: Two hundred and eighty-five samples were collected, of which 185 samples were from rodents and 100 from domestic chickens. Microscopy after modified Ziehl-Neelsen staining and nested polymerase chain reaction targeting the small subunit (SSU) rRNA gene were used to examine Cryptosporidium spp. Results: The overall prevalence of Cryptosporidium oocysts was 55.8%, with a prevalence of 72.4% in rodents and 25.0% in domestic chickens. Molecular analysis showed that Cryptosporidium spp. were present in 4.0% of the samples. No significant correlation was observed between Cryptosporidium spp. carriage and sex or location in this study. These results indicate that Cryptosporidium spp. persist and circulate in the studied animal species in Franceville, Gabon. Conclusion: Infection with Cryptosporidium is very common in rodents and chickens in Franceville. The potential risk of human contamination cannot be ruled out. More research should be conducted to characterize Cryptosporidium species circulating in rodents and chickens in Gabon. Such studies are essential to better understand the epidemiology of this protozoan and its potential impact on public health. [ABSTRACT FROM AUTHOR]

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the leading causes of mortality due to bacterial antimicrobial resistance. While S. aureus is common in skin and soft tissue infections (SSTI) in Africa, data on MRSA rates are scarce and reports vary widely across the continent (5%-80%). In this study, we describe the proportion of MRSA causing SSTI in Lambaréné, Gabon, over an 11-year period. Methods: We retrospectively analyzed data from 953 bacterial specimens collected from inpatients and outpatients with SSTI at the Albert Schweitzer Hospital, Lambaréné, Gabon, between 2009 and 2019. We determined temporal changes in the prevalence of MRSA and identified risk factors for SSTI with MRSA. Results: 68% of all specimens with bacterial growth yielded S. aureus (n = 499/731), of which 7% (36/497) with antimicrobial susceptibility testing were identified as MRSA. Age above 18 years, admission to the surgical ward, and deep-seated infections were significantly associated with MRSA as the causative agent. After an initial decline from 7% in 2009, there was a marked increase in the proportion of MRSA among all S. aureus from SSTI from 3 to 20% between 2012 and 2019. The resistance rate to erythromycin was significantly higher in MRSA than in methicillin-susceptible S. aureus (73% vs. 10%), and clindamycin resistance was detected exclusively in MRSA isolates (8%). Conclusion: The increasing proportion of MRSA causing SSTI over the 11-year period contrasts with many European countries where MRSA is on decline. Continuous surveillance of MRSA lineages in the hospital and community along with antibiotic stewardship programs could address the increasing trend of MRSA. [ABSTRACT FROM AUTHOR]

Background: The world health organization's global health observatory defines maternal mortality as annual number of female deaths, regardless of the period or location of the pregnancy, from any cause related to or caused by pregnancy or its management (aside from accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy and an estimated 287 000 women worldwide passed away from maternal causes between 2016 and 2020, that works out to be about 800 deaths per day or about one every two minutes. Method: The most recent 2018–2023 DHS data set of 14 SSA countries was used a total of 89,489 weighted mothers who gave at list one live birth 3 years preceding the survey were included, a multilevel analysis was conducted. In the bi-variable analysis variables with p-value ≤ 0.20 were included in the multivariable analysis, and in the multivariable analysis, variables with p-value less than ≤ 0.05 were considered to be significant factors associated with having eight and more ANC visits. Result: The magnitude of having eight and more ANC visits in 14 sub-Saharan African countries was 8.9% (95% CI: 8.76–9.13) ranging from 3.66% (95% CI: 3.54–3.79) in Gabon to 18.92% (95% CI: 18.67–19.17) in Nigeria. The multilevel analysis shows that maternal age (40–44, AOR;2.09, 95%CI: 1.75–2.53), maternal occupational status (AOR;1.14, 95%CI; 1.07–1.22), maternal educational level (secondary and above, AOR;1.26, 95%CI; 1.16–1.38), wealth status(AOR;1.65, 95%CI; 1.50–1.82), media exposure (AOR;1.20, 95%CI; 1.11–1.31), pregnancy intention (AOR;1.12, 95%CI; 1.05–1.20), ever had terminated pregnancy (AOR;1.16 95%CI; 1.07–1.25), timely initiation of first ANC visit (AOR;4.79, 95%CI; 4.49–5.10), empowerment on respondents health care (AOR;1.43, 95%CI; 1.30–1.56), urban place of residence (AOR;1.33, 95%CI; 1.22–1.44) were factors highly influencing the utilization of AN. On the other hand higher birth order (AOR;0.54, 95%CI; 0.53–0.66), not using contraceptive (AOR;0.80, 95%CI; 0.75–0.86) and survey year (AOR;0.47, 95%CI; 0.34–0.65) were factors negatively associated with having eight and more ANC visits. Conclusion: In the 14 SSA included in this study, there is low adherence to WHO guidelines of eight and more ANC visits. Being educated, having jobs, getting access to media being from rural residence and rich wealth group contribute to having eight and more ANC visits, so we highly recommend policy implementers to advocate this practices. [ABSTRACT FROM AUTHOR]

Background: Despite dengue virus (DENV) outbreak in Gabon a decade ago, less is known on the potential circulation of DENV serotypes in the country. Previous studies conducted in some areas of the country, are limited to hospital-based surveys which reported the presence of some cases of serotype 2 and 3 seven years ago and more recently the serotype 1. As further investigation, we extend the survey to the community of Moyen Ogooué region with the aim to assess the presence of the dengue virus serotypes, additionally to characterize chikungunya (CHIKV) infection and describe the symptomatology associated with infections. Method: A cross-sectional survey was conducted from April 2020 to March 2021. The study included participants of both sexes and any age one year and above, with fever or history of fever in the past seven days until blood collection. Eligible volunteers were clinically examined, and blood sample was collected for the detection of DENV and CHIKV using RT-qPCR. Positive samples were selected for the target sequencing. Results: A total of 579 volunteers were included. Their mean age (SD) was 20 (20) years with 55% of them being female. Four cases of DENV infection were diagnosed giving a prevalence of 0.7% (95%CI: 0.2–1.8) in our cohort while no case of CHIKV was detected. The common symptoms and signs presented by the DENV cases included fatigue, arthralgia myalgia, cough, and loss of appetite. DENV-1was the only virus detected by RT-qPCR. Conclusion: Our results confirm the presence of active dengue infection in the region, particularly DENV-1, and could suggest the decline of DENV-2 and DENV-3. Continuous surveillance remains paramount to comprehensively describe the extent of dengue serotypes distribution in the Moyen-Ogooué region of Gabon. [ABSTRACT FROM AUTHOR]

Introduction: Stunting is still a major public health problem all over the world, it affecting more than one-third of under-five children in the world that leads to growth retardation, life-threatening complication and accelerate mortality and morbidity. The evidence is scarce on prevalence and associated factors of stunting among under-five children in Sub-Saharan Africa for incorporated intervention. Therefore this study aimed to investigate the prevalence and determinants of stunting among under-five children in Sub-Saharan Africa using recent demographic and health surveys of each country. Methods: This study was based on the most recent Demographic and Health Survey data of 36 sub-Saharan African countries. A total of 203,852(weighted sample) under-five children were included in the analysis. The multi-level ordinal logistic regression was fitted to identify determinants of stunting. Parallel line (proportional odds) assumption was cheeked by Brant test and it is satisfied (p-value = 0.68) which is greater than 0.05. Due to the nested nature of the dataset deviance was used model comparison rather than AIC and BIC. Finally the adjusted odds ratio (AOR) with 95% CI was reported identify statistical significant determinants of stunting among under-five children. Results: In this study, the prevalence of stunting among under-five children in Sub-Saharan Africa 34.04% (95% CI: 33.83%, 34.24%) with a large difference between specific countries which ranges from 16.14% in Gabon to 56.17% in Burundi. In the multi-level ordinal logistic regression good maternal education, born from mothers aged above 35 years, high household wealth status, small family size, being female child, being female household head, having media exposure and having consecutive ANC visit were significantly associated with lower odds of stunting. Whereas, living from rural residence, being 24–59 month children age, single or divorced marital status, higher birth order and having diarrhea in the last two weeks were significantly associated with higher odds of stunting. Conclusion: Stunting among under-five children is still public health problem in Sub-Saharan Africa. Therefore designing interventions to address diarrhea and other infectious disease, improving the literacy level of the area and increase the economic level of the family to reduce the prevalence of stunting in the study area. [ABSTRACT FROM AUTHOR]

Aim: To describe the expectations, acceptability, and challenges identified by nurses and key healthcare stakeholders regarding the implementation of advanced practice nursing in Gabon. Background: Advanced practice nursing presents an opportunity to address the epidemiological transition and the shortage of healthcare professionals in Africa. In anticipation of establishing a master's degree program in advanced practice nursing and its subsequent implementation, it is important to understand Gabon's specific needs and characteristics. Design: This study used a multicenter cross‐sectional mixed‐method design. Methods: From April to May 2022, a total of 187 healthcare professionals were included from two hospitals and two universities in Gabon. Data were collected through questionnaires and complemented by focus group discussions, guided by the existing literature, the PEPPA framework, and Hamric's model. Results: The implementation of advanced practice nursing was generally well accepted. Factors influencing acceptability included being female, awareness of advanced practice nursing, and supporting the role of advanced practice nurses in diagnosing chronic diseases. Barriers to implementation included the absence of a legal framework for the profession and a lack of recognition of nursing skills by both nurses and doctors. Facilitators included the establishment of a master's degree program, formalization of a legal framework, raising awareness, providing training to medical doctors and other healthcare professionals about advanced practice nursing, and the development of nursing leadership. Implications for nursing: Advanced practice nursing can play a crucial role in addressing healthcare resource shortages and the dual burden of chronic and infectious diseases in Gabon, as well as in other African countries. Implications for nursing policy: To successfully implement advanced practice nursing in Gabon and French‐speaking Africa, it is essential to regulate the nursing and advanced nursing professions by creating a legal framework and establishing nursing councils. An effective implementation strategy for advanced practice nurses should be based on the specific needs of the country. Guidelines: COREQ, STROBE [ABSTRACT FROM AUTHOR]

The adaptation of Anopheles malaria vectors to domestic settings is directly linked to their ability to feed on humans. The strength of this species–habitat association is unequal across the species within the genus, with the major vectors being particularly dependent on humans. However, our understanding of how blood‐feeding behavior interacts with and adapts to environmental settings, including the presence of humans, remains limited. Using a field‐based approach, we first investigated Anopheles community structure and feeding behavior patterns in domestic and sylvatic settings in La Lopé National Park in Gabon, Central Africa. We characterized the preference indices using a dual‐host choice sampling approach across mosquito species, habitats, and seasons. We then quantified the plastic biting behavior of mosquito species in each habitat. We collected individuals from 16 Anopheles species that exhibited significant differences in species composition and abundance between sylvatic and domestic settings. The host‐seeking behavior also varied among the seven most abundant species. The general attractiveness to each host, human or animal, remained relatively constant for each species, but with significant variations between habitats across species. These variations, to more generalist and to more anthropophilic behavior, were related to seasonal changes and distance from the village, respectively. Finally, we pointed out that the host choice of major malaria vectors changed in the absence of humans, revealing a plastic feeding behavior of these species. This study highlights the effect of humans on Anopheles distribution and feeding evolution. The characterization of feeding behavior in wild and domestic settings provides opportunities to better understand the interplay between genetic determinants of host preference and ecological factors. Our findings suggest that protected areas may offer alternative thriving conditions to major malaria vectors. [ABSTRACT FROM AUTHOR]

This document presents the results of a study on the length-weight relationships (LWR) of 13 fish species in the Akanda National Park in Gabon. The study found a strong correlation between size and weight for these species. Additionally, the study revealed that many of the fish caught were juveniles, providing insights into the reproductive biology of these species. The information provided in this document can be valuable for researchers studying fish populations and ecosystems in Gabon. [Extracted from the article]

Background: More than 20 million people are infected with L. loa, and around 40 million live in high or intermediate-risk areas in West- and Central Africa. Although loiasis is associated with significant morbidity and excess mortality, little is known about the perception of loiasis by affected communities. This study assessed the knowledge, attitudes, and practices in the rural population of Sindara, Gabon, a region characterized by high loiasis prevalence. Methods: A community-based cross-sectional survey was conducted in Gabon between January and June 2022. During systematic door-to-door visits, randomly selected inhabitants were invited to participate in this questionnaire based survey. Venous blood was collected at midday from all participants for microscopic detection of filarial infection and clinical signs of loiasis were assessed. Results: A total of 150 participants were recruited, of which 66% were infected by L. loa. While almost everyone had some knowledge about L. loa, 72% of the participants understood that L. loa is a parasitic worm. The transmission of L. loa via the deer fly was known to only 21% of participants. The most frequently mentioned clinical symptoms attributed to loiasis were itching (84%), eye worm migration (59%), and conjunctivitis-like symptoms (53%). Participants who experienced migratory loiasis had better knowledge of loiasis and considered it as more serious. Traditional and herbal medicine was reported most often as an available treatment option (72%). While the formal healthcare sector was mentioned as the preferred treatment provider, 60% of the reported infections were treated by traditional medical practitioners. Conclusion: Loiasis is in general well known by this community residing in a region of high L. loa transmission. Important gaps in knowledge were discovered foremost regarding the mode of transmission. The available healthcare system does not seem to provide adequate management for loiasis. Author summary: Loiasis is a filarial disease highly prevalent in parts of Western- and Central Africa. For a long time, the disease has been considered to be a relatively benign condition, but recent studies have shown that loiasis causes significant morbidity and excess mortality. In the present study, we investigated the perception of loiasis in a highly affected community in rural Gabon to better understand the community perspective on this infectious disease. While L. loa as a disease is known to most inhabitants, the mode of transmission and prevention modalities are only poorly understood. This lack of knowledge leaves the communities with inadequate means to prevent onward transmission of this filarial disease. The contribution from media, schools and healthcare institutions in providing information about loiasis is inadequate, and the available healthcare system is insufficient to provide the necessary care for loiasis. A better understanding of loiasis by the affected communities is desirable to empower inhabitants of high-transmission regions to better protect themselves from loiasis. Improved understanding of the disease by the healthcare sector is necessary to improve the management of loiasis. [ABSTRACT FROM AUTHOR]

Background: Chronic infection by Loa loa remains an unsolved immunological paradox. Despite harboring subcutaneously migrating adult worms and often high densities of microfilariae, most patients experience only relatively mild symptoms, yet microfilaricidal treatment can trigger life-threatening inflammation. Here, we investigated innate cell populations hypothesized to play a role in these two faces of the disease, in an endemic population in Gabon. Methodology/Principal findings: We analyzed numbers and activation of eosinophils and basophils, as well as myeloid-derived suppressor cell (MDSC) subsets and associated circulating cytokine levels by flow cytometry in sex- and age-matched L. loa-uninfected (LL-), -amicrofilaraemic (MF-) and -microfilaraemic (MF+) individuals (n = 42), as well as microfilaraemic individuals treated with albendazole (n = 26). The percentage of eosinophils was lower in LL- (3.0%) than in the combined L. loa-infected population, but was similar in MF+ (13.1%) and MF- (12.3%). Upon treatment of MF+, eosinophilia increased from day 0 (17.2%) to day 14 (24.8%) and had decreased below baseline at day 168 (6.3%). Expression of the eosinophil activation marker CD123 followed the same pattern as the percentage of eosinophils, while the inverse was observed for CD193 and to some extent CD125. Circulating IL-5 levels after treatment followed the same pattern as eosinophil dynamics. Basophil numbers did not differ between infection states but increased after treatment of MF+. We did not observe differences in MDSC numbers between infection states or upon treatment. Conclusions/Significance: We demonstrate that both chronic infection and treatment of L. loa microfilaraemia are associated with eosinophil circulation and distinct phenotypical activation markers that might contribute to inflammatory pathways in this setting. In this first ever investigation into MDSC in L. loa infection, we found no evidence for their increased presence in chronic loiasis, suggesting that immunomodulation by L. loa is induced through other pathways. Author summary: Loiasis–also called African eye worm for its most pathognomonic feature–is a disease caused by the helminth Loa loa, affecting over ten million people in Central and West Africa. While L. loa seems to successfully evade an effective immune response in chronic infection, treatment can lead to severe inflammation upon rapid death of L. loa larvae in the blood. Here, we investigated different subsets of immune cells hypothesized to play a role in L. loa-mediated immune modulation in chronically infected individuals and upon treatment of individuals with circulating larvae. We found that eosinophils–an important cell population in the immune response to helminths–increase in numbers and are activated in both L. loa-infection and its treatment. Myeloid-derived suppressor cells can suppress immune responses in cancer and some other infectious diseases but have never been investigated in loiasis. We hypothesized that they are involved in immunosuppression by L. loa but found no evidence thereof. Better understanding of immunomodulation in chronic loiasis may ultimately improve the management of this neglected disease. [ABSTRACT FROM AUTHOR]

Background: Chronic carriage of intestinal parasitic infections (IPIs) can induce chronic inflammation and dysbiosis, which are risk factors for non-communicable diseases. The objective of this study was to determine the relationship between IPI carriage and inflammation in a population of volunteers living in Gabon. Methodology and principal findings: A cross-sectional study was conducted from September 2020 to November 2021 in asymptomatic volunteers aged 18 years old and over, residing in different areas of Gabon: Libreville (urban area) and Koula-Moutou and Bitam (rural areas). The detection of IPIs was carried out using four common microscopic techniques. C-reactive protein (CRP), and high-sensitivity C-reactive protein (hsCRP) were measured and levels were compared according to the presence or absence of IPI. Overall, 518 participants were included, 64.5% (n = 334) of whom resided in urban area and 35.5% (n = 184) in rural areas. The median age was 35 years (27; 46). The prevalence of asymptomatic IPIs was 29.9% (n = 155), with a significantly higher frequency in rural areas than in urban area (adjusted OR 6.6 (CI 3.2–13.8), p < 0.01). Protozoa were more frequent than soil-transmitted helminths (STHs) in both areas: 81.6% (n = 40) in urban area and 69.8% (n = 74) in rural areas. STHs were predominant in rural areas (48.1% vs 22.4% in urban area. In case of IPI, the median values of CRP (15 (13–15) mg/L vs 13.0 (11.1–14.9) mg/L) and hsCRP (4.2 (1.4–13.0) mg/L vs 2.2(0.4–6.1) mg/L) were higher (p<0.01). Elevated hsCRP and CRP were significantly more frequent in parasitized individuals (for hsCRP: 22.6%, n = 35; for CRP: 52.9%, n = 82); in particular among STH carriers (for hsCRP: 65.9%, n = 27, for CRP: 36.6%, n = 15) (p < 0.01). Conclusions/Significance: This first study showed that asymptomatic IPIs, particularly STH carriage are associated with high CRP and hsCRP levels. Further larger and longitudinal studies are needed to elucidate the global and specie-specific enteropathogens link with chronic inflammation. Author summary: Repeated or chronic parasitism can maintain local or systemic chronic inflammation, CRP and hsCRP are sensitive biomarkers of subclinical low-grade inflammation. This study assessed the serum levels of CRP and hsCRP in adults with or without intestinal parasite (IPI) carriage according to residence area and parasite species. IPI chronic carriage, especially with pathogenic protozoa and/or STH, was associated with higher levels of CRP and hsCRP. These findings suggest that intestinal parasite carriage contributes to low grade systemic inflammation which is a driver of NCD. The role of chronic carriage of other enteropathogens on chronic inflammation status as well the relationship between IPI and dysbiosis should be further analyzed in endemic countries. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the spatial distribution of Anopheles mosquito larval habitats and the environmental factors associated with them, as a prerequisite for the implementation of larviciding. Methods: The study was conducted in December 2021, during the transition period between the end of the short rainy season (September–November) and the short dry season (December-February). Physical, biological, and land cover data were integrated with entomological observations to collect Anopheles larvae in three major towns: Mitzic, Oyem, and Bitam, using the "dipping" method during the transition from rainy to dry season. The collected larvae were then reared in a field laboratory established for the study period. After the Anopheles mosquitoes had emerged, their species were identified using appropriate morphological taxonomic keys. To determine the influence of environmental factors on the breeding of Anopheles mosquitoes, multiple-factor analysis (MFA) and a binomial generalized linear model were used. Results: According to the study, only 33.1% out of the 284 larval habitats examined were found to be positive for Anopheles larvae, which were primarily identified as belonging to the Anopheles gambiae complex. The findings of the research suggested that the presence of An. gambiae complex larvae in larval habitats was associated with various significant factors such as higher urbanization, the size and type of the larval habitats (pools and puddles), co-occurrence with Culex and Aedes larvae, hot spots in ambient temperature, moderate rainfall, and land use patterns. Conclusions: The results of this research mark the initiation of a focused vector control plan that aims to eradicate or lessen the larval habitats of An. gambiae mosquitoes in Gabon's Woleu Ntem province. This approach deals with the root causes of malaria transmission through larvae and is consistent with the World Health Organization's (WHO) worldwide objective to decrease malaria prevalence in regions where it is endemic. [ABSTRACT FROM AUTHOR]

Human consumption of insects has previously been examined in cross-cultural studies. However, such studies rarely include African countries and willingness-to-pay for insect-based food has never been assessed in cross-cultural studies. The current study presents a cross-cultural study conducted with 409 urban dwellers from Belgium (191 males; 218 females) and 412 urban dwellers from Gabon (219 males; 193 females). Each respondent was surveyed with a questionnaire following the Knowledge, Attitude, and Practices model and included questions relative to willingness-to-pay for 2 insect-based foods (insect baguette and insect burger). More than 90% of respondents from both countries were familiar with edible insects. However, acceptance of entomophagy was lower in respondents from Gabon than in respondents from Belgium. Intercultural differences were also recorded between Gabonese ethnic groups. Most respondents who accepted entomophagy were willing to eat the insect baguette and/or the insect burger. These findings confirm that entomophagy could further develop in Belgium and Gabon. Willingness-to-pay varied between countries and between insect-based foods. In Belgium, the average prices of comparable conventional foods (i.e. same foods but without insects) were lower than the average willingness-to-pay for insect-based foods. In Gabon, respondents were not willing to pay extra for insect-based foods. Setting the right price for insect-based foods is a necessary step to promote more frequent insect consumption. [ABSTRACT FROM AUTHOR]

The cornerstone of malaria prevention in pregnancy, intermittent preventive treatment (IPTp) with sulfadoxine–pyrimethamine, is contraindicated in women with HIV who are receiving co-trimoxazole prophylaxis. We assessed whether IPTp with dihydroartemisinin–piperaquine is safe and effective in reducing the risk of malaria infection in women with HIV receiving co-trimoxazole prophylaxis and antiretroviral drugs. For this randomised, double-blind, placebo-controlled clinical trial, women with HIV attending the first antenatal care clinic visit, resident in the study area, and with a gestational age up to 28 weeks were enrolled at five sites in Gabon and Mozambique. Participants were randomly assigned (1:1) to receive either IPTp with dihydroartemisinin–piperaquine at each scheduled antenatal care visit plus daily co-trimoxazole (intervention group) or placebo at each scheduled antenatal care visit plus daily co-trimoxazole (control group). Randomisation was done centrally via block randomisation (block sizes of eight), stratified by country. IPTp was given over 3 days under direct observation by masked study personnel. The number of daily IPTp tablets was based on bodyweight and according to the treatment guidelines set by WHO (target dose of 4 mg/kg per day [range 2–10 mg/kg per day] of dihydroartemisinin and 18 mg/kg per day [range 16–27 mg/kg per day] of piperaquine given once a day for 3 days). At enrolment, all participants received co-trimoxazole (fixed combination drug containing 800 mg trimethoprim and 160 mg sulfamethoxazole) for daily intake. The primary study outcome was prevalence of peripheral parasitaemia detected by microscopy at delivery. The modified intention-to-treat population included all randomly assigned women who had data for the primary outcome. Secondary outcomes included frequency of adverse events, incidence of clinical malaria during pregnancy, and frequency of poor pregnancy outcomes. All study personnel, investigators, outcome assessors, data analysts, and participants were masked to treatment assignment. This study is registered with ClinicalTrials.gov , NCT03671109. From Sept 18, 2019, to Nov 26, 2021, 666 women (mean age 28·5 years [SD 6·4]) were enrolled and randomly assigned to the intervention (n=332) and control (n=334) groups. 294 women in the intervention group and 308 women in the control group had peripheral blood samples taken at delivery and were included in the primary analysis. Peripheral parasitaemia at delivery was detected in one (<1%) of 294 women in the intervention group and none of 308 women in the control group. The incidence of clinical malaria during pregnancy was lower in the intervention group than in the control group (one episode in the intervention group vs six in the control group; relative risk [RR] 0·12, 95% CI 0·03–0·52, p=0·045). In a post-hoc analysis, the composite outcome of overall malaria infection (detected by any diagnostic test during pregnancy or delivery) was lower in the intervention group than in the control group (14 [5%] of 311 women vs 31 [10%] of 320 women; RR 0·48, 95% CI 0·27–0·84, p=0·010). The frequency of serious adverse events and poor pregnancy outcomes (such as miscarriages, stillbirths, premature births, and congenital malformations) did not differ between groups. The most frequently reported drug-related adverse events were gastrointestinal disorder (reported in less than 4% of participants) and headache (reported in less than 2% of participants), with no differences between study groups. In the context of low malaria transmission, the addition of IPTp with dihydroartemisinin–piperaquine to co-trimoxazole prophylaxis in pregnant women with HIV did not reduce peripheral parasitaemia at delivery. However, the intervention was safe and associated with a decreased risk of clinical malaria and overall Plasmodium falciparum infection, so it should be considered as a strategy to protect pregnant women with HIV from malaria. European and Developing Countries Clinical Trials Partnership 2 (EDCTP2) and Medicines for Malaria Venture. For the Portuguese and French translations of the abstract see Supplementary Materials section. [ABSTRACT FROM AUTHOR]

Knowledge about the vertical structure of forests, such as forest height, above-ground biomass (AGB), and the vertical biomass distribution is important for understanding carbon allocation, structural diversity, and succession and degradation dynamics in forest ecosystems. While the use of lidar (light detection and ranging) observations is well established to investigate the vertical structure of forests, the sensitivity of P-band synthetic aperture radar tomography (TomoSAR) observations to biomass and vertical forest structure is not yet well understood. Here we use lidar observations from NASA's Global Ecosystem Dynamics Investigation (GEDI) to analyse the sensitivity of airborne P-band SAR tomography backscatter to forest height and AGB at two tropical forests in Lopé and Mondah, Gabon, Africa. We use GEDI observations to parametrize an empirical model for estimating forest height and we use a random forest model for estimating AGB from TomoSAR profiles. The validation with Land, Vegetation, and Ice Sensor (LVIS) airborne lidar data shows moderate performance for estimating forest height (RMSE = 8.2 m in Lopé and 9.8 m in Mondah) and moderate to good performance for total AGB (RMSE = 115.3 Mg/ha in Lopé and 117.8 Mg/ha in Mondah). We also estimated the vertical distribution of AGB using the corrected TomoSAR backscatter and compared it with AGB profiles derived from field observations in Mondah, which indicates potential to use TomoSAR observations for estimating vertical AGB distribution over tropical forests. However, our results demonstrate the need for targeted field observations of vertical biomass profiles in order to make full use of P-band TomoSAR to map the vertical structure of tropical forests. [ABSTRACT FROM AUTHOR]

Acute respiratory infections are a major global burden in resource-limited countries, including countries in Africa. Although COVID-19 has been well studied since the pandemic emerged in Gabon, Central Africa, less attention has been paid to other respiratory viral diseases, and very little data are available. Herein, we provide the first data on the genetic diversity and detection of 18 major respiratory viruses in Gabon during the COVID-19 pandemic. Of 582 nasopharyngeal swab specimens collected from March 2020 to July 2021, which were SARS-CoV-2 negative, 156 were positive (26%) for the following viruses: enterovirus (20.3%), human rhinovirus (HRV) (4.6%), human coronavirus OC43 (1.2%), human adenovirus (0.9%), human metapneumovirus (hMPV) (0.5%), influenza A virus (IAV) (0.3%), and human parainfluenza viruses (0.5%). To determine the genetic diversity and transmission route of the viruses, phylogenetic analyses were performed using genome sequences of the detected viruses. The IAV strain detected in this study was genetically similar to strains isolated in the USA, whereas the hMPV strain belonging to the A2b subtype formed a cluster with Kenyan strains. This study provides the first complete genomic sequences of HRV, IAV, and hMPV detected in Gabon, and provides insight into the circulation of respiratory viruses in the country. [ABSTRACT FROM AUTHOR]

Background: The prevalence of cardiometabolic risk factors (CMRFs) is increasing in sub-Saharan Africa and represents a serious public health issue. Accurate data are required to implement adapted prevention programs and healthcare strategies. Thus, the aim of this study was to estimate the prevalence rates of CMRFs according to the level of urbanization, age and gender in Gabon. Methods: A cross-sectional study was conducted in northern (Bitam), western coast (Libreville, Melen) and southeast (Koulamoutou) areas of Gabon using the World Health Organization's (WHO) stepwise approach for the surveillance of chronic disease risk factors. Participants over 18 years of age, without known underlying disease, living in rural and urban areas of Gabon were included. Sociodemographic, biological, and behavioral data were collected. Univariate and multivariate analysis were used to identify the CMRFs. Results: Of the 978 participants, 499 lived in urban and 479 in rural areas. Their median age was 38[28–50] years. Tobacco (26.1% vs 6.2%; p < 0.01) and excessive alcohol consumption (19.4% vs 9.6%; p < 0.01) predominated in rural than in urban areas, respectively. Urban dwellers had more often insufficient physical activity than rural people (29.5% vs 16.3%; p < 0.01). In total, 79.9% of participants aged under 54 years had a high blood pressure;10.6% of the younger participants had pre-hypertension. Metabolic syndrome was more frequent in women (21.7%) than in men (10.0%) (p < 0.01); 6.4% of men and 2.5% of women had a high Framingham score (p = 0.03). Finally, 54.0% of the participants had three or four CMRFs. The multivariate analysis showed that men were more likely to be smokers and to be at risk of pre-hypertension or high blood pressure (p < 0.01). Women were more likely to be obese or to have a metabolic syndrome (p < 0.01). Living in urban areas was also a risk factor for hypertension, diabetes, metabolic syndrome and high LDL cholesterol level. Conclusion: The prevalence of CMRFs was high in the study population. Disparities were observed according to urban and rural areas, gender and age. National prevention and healthcare strategies for cardiometabolic diseases in Gabon should consider these observed differences. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine performance indicators of thick blood smears of 50 µl (TBS-50), following the Standards for the Reporting of Diagnostic Accuracy Studies–Bayesian Latent Class Model (STARD-BLCM) guidelines. TBS-50 was compared with two common parasitological techniques—direct examination of 10 µl blood and a leukoconcentration of 5 ml—for the diagnosis of microfilaremic loiasis. Methods: The study population was recruited among patients of the Department of Parasitology-Mycology-Tropical Medicine over a period of 1 year. Age, sex, symptoms, and eosinophilia variables were recorded from laboratory registers and medical files. Direct examination of 10 µl of blood, TBS-50, and the leukoconcentration technique with 5 ml of blood were performed for each patient. The classical formula and BLCM were used to determine the diagnostic accuracy of the three techniques as well as the prevalence of microfilaremic loiasis. Three models were built within the framework of BLCM—the BLCM model I and alternative models II and III—for sensitivity analysis. Results: In total, 191 patients consented to be included. The direct blood examination and TBS-50 yielded comparable qualitative and quantitative results. Hence, they are reported together. The prevalence of Loa loa microfilaremia was 9.4% (95% CI 5.7–14.5; n = 18/191) with direct blood examination/TBS-50 and 12.6% [8.2–18.1] (n = 24/191) for leukoconcentration. Comparing TBS-50 with the leukoconcentration method using the classical formula, the sensitivity was 75.0% [53.3–90.2], specificity was 100.0% [97.8–100.0], the positive predictive value was 100.0% [81.5–100.0], and the negative predictive value was 96.5% [92.6–98.7]. The prevalence of microfilaremic loiasis was estimated at 9.7% [6.2–13.7] using BLCM model I. The outputs of BLCM model I showed sensitivity of 78.9% [65.3–90.3], specificity of 100.0% [99.3–100.0], a positive predictive value of 99.1% [87.2–100.0], and a negative predictive value of 93.0% [87.3–97.7] for direct blood examination/TBS-50. Conclusions: TBS-50 demonstrates low sensitivity relative to two other techniques. In one in five cases, the result will be falsely declared negative using these methods. However, this method can be deployed with limited funds. [ABSTRACT FROM AUTHOR]

Background: The parasitic disease loiasis is associated with significant morbidity and mortality. Individuals with hyper-microfilaremia (greater than 20,000 microfilariae per mL of blood) may suffer from serious treatment-related or spontaneous adverse events. Diagnosing loiasis remains complex and primarily relies on direct parasite detection. In this study, we analyzed the performance of various diagnostic tests and the influence of parasitological and clinical factors on test outcomes in samples from individuals living in an endemic region. Methods: Data and samples were collected from rural Gabon. Loiasis was defined as either detectable microfilaremia, or a positive history of eyeworm as assessed by the RAPLOA questionnaire. Diagnostic testing included a quantitative PCR (qPCR) for detection of Loa loa DNA in blood samples, an in-house crude L. loa antigen IgG ELISA, and a rapid test for antibodies against the Ll-SXP-1 antigen (RDT). Sensitivity and specificity were determined for each test and factors potentially influencing outcomes were evaluated in an exploratory analysis. Results: ELISA, RDT and qPCR results were available for 99.8%, 78.5%, and 100% of the 1,232 participants, respectively. The ELISA and RDT had only modest diagnostic accuracy. qPCR was specific for L. loa microfilaremia and Cycle threshold values correlated with microfilarial density. Anti-L. loa IgG levels were highest in occult loiasis, and antibody levels correlated inversely with L. loa microfilarial density as did RDT line intensities. Only 84.6% and 16.7% of hyper-microfilaremic individuals tested positive by ELISA (11/13) and RDT (2/12), respectively. Conclusion: None of the tests demonstrated high sensitivity and specificity for loiasis. Indirect diagnostic assays were characterized by low specificity. Additionally, hyper-microfilaremic individuals often tested negative by RDT and ELISA, indicating that these tests are not suitable for individual case management in endemic populations. Author summary: Loiasis remains highly neglected despite recent evidence of significant loiasis-associated mortality and morbidity. This complex disease is difficult to diagnose, especially in endemic populations. Here, we assessed the performance of several diagnostic assays. In addition, an exploratory analysis of factors associated with the outcomes of indirect, serology-based tests was performed. The presented data show only moderate performance of indirect tests. Furthermore, amicrofilaremic loiasis was associated with higher quantitative serological test results. None of the indirect tests detected all cases of microfilaremic loiasis, including individuals with high and hyper-microfilaremia. As a negative test may not reliably exclude hyper-microfilaremic infections, these serological tests should not be used as screening tests in individual case management. This is important, as hyper-microfilaremic individuals are at increased risk of developing serious adverse events after treatment with drugs such as ivermectin or diethylcarbamazine. [ABSTRACT FROM AUTHOR]

Introduction: In 2022, the WHO reported that 29.8 million people around the world were living with HIV (PLHIV) and receiving antiretroviral treatment (ART), including 25‌ 375 people in Gabon (54% of all those living with HIV in the country). The literature reports a frequency of therapeutic failure with first-line antiretrovirals (ARVs) of between 20% and 82%. Unfortunately, data relating to the failure of second-line ARVs are scarce in Gabon. This study aims to determine the profiles of HIV drug resistance mutations related to protease inhibitors in Gabon. Methodology: Plasma from 84 PLHIV receiving ARVs was collected from 2019 to 2021, followed by RNA extraction, amplification, and sequencing of the protease gene. ARV resistance profiles were generated using the Stanford interpretation algorithm version 8.9-1 (https://hivdb.stanford.edu) and statistical analyses were performed using EpiInfo software version 7.2.1.0 (CDC, USA). Results: Of 84 HIV plasma samples collected from 45 men and 39 women, 342 mutations were detected. Of these, 43.3% (148/342) were associated with nucleoside reverse transcriptase inhibitors (NRTIs), 30.4% (104/342) with non-nucleoside reverse transcriptase inhibitors (NNRTIs), and 26.3% (90/342) with protease inhibitors (PIs). Most NRTI mutations were associated with thymidine analogues (TAMs) (50.7%; 75/148), including T215F/V (14.9%; 22/148), D67DN/E/G/N/T (10.1%; 15/148), M41L (9.5%; 14/148), and K70E/KN/S/R (9.5%; 14/148). Resistance mutations related to non-TAM NRTIs (33.1%; 49/148) were M184V (29.1%; 43/148), and L74I/V (8.1%; 12/148). NNRTI mutations were predominantly K103N/S (32.7%; 34/104), V108I (10.6%; 11/104), A98G (10.6%; 11/104), and P225H (9.6%; 10/104). Minor mutations associated with PIs (60.0%; 54/90) were predominantly K20I (15.6%; 14/90) and L10F/I/V (14.5%; 13/90). The major mutations associated with PIs (40.0%; 36/90) were M41L (12.2%; 11/90), I84V (6.7%; 06/90), and V82A (6.7%; 06/90). The four most prescribed therapeutic regimens were TDF + 3TC + LPV/r (20.3%; 17/84), ABC + DDI + LPV/r (17.9%; 15/84), TDF + FTC + LPV/r (11.9%; 10/84), and ABC + 3TC + LPV/r (11.9%; 10/84). Conclusion: This study revealed that HIV drug resistance mutations are common in Gabon. The major mutations associated with PIs were M41L, I84V, and V82A. There is a need for access to new NRTIs, NNRTIs, and PIs for a better therapeutic management of PLHIV in Gabon. [ABSTRACT FROM AUTHOR]

Rift Valley fever (RVF) is a mosquito-borne viral zoonosis caused by the Rift Valley fever virus (RVFV) that can infect domestic and wild animals. Although the RVFV transmission cycle has been well documented across Africa in savanna ecosystems, little is known about its transmission in tropical rainforest settings, particularly in Central Africa. We therefore conducted a survey in northeastern Gabon to assess RVFV circulation among wild and domestic animals. Among 163 wildlife samples tested using RVFV-specific RT-qPCR, four ruminants belonging to subfamily Cephalophinae were detected positive. The phylogenetic analysis revealed that the four RVFV sequences clustered together with a virus isolated in Namibia within the well-structured Egyptian clade. A cross-sectional survey conducted on sheep, goats and dogs living in villages within the same area determined the IgG RVFV-specific antibody prevalence using cELISA. Out of the 306 small ruminants tested (214 goats, 92 sheep), an overall antibody prevalence of 15.4% (95% CI [11.5–19.9]) was observed with a higher rate in goats than in sheep (20.1% versus 3.3%). RVFV-specific antibodies were detected in a single dog out of the 26 tested. Neither age, sex of domestic animals nor season was found to be significant risk factors of RVFV occurrence. Our findings highlight sylvatic circulation of RVFV for the first time in Gabon. These results stress the need to develop adequate surveillance plan measures to better control the public health threat of RVFV. Author summary: Rift Valley fever (RVF) is a mosquito-borne viral zoonosis caused by the Rift Valley fever virus (RVFV) that can affect wild and domestic animals. Although the RVFV transmission cycle has been well documented across Africa in savanna ecosystems, little is known about its transmission in tropical rainforests, especially in Central Africa. We thus conducted a survey in northeastern Gabon to assess RVFV circulation among wild and domestic animals. In this study, we demonstrated for the first time in Gabon the presence of the RVFV in two wildlife species (Peter's duiker Cephalophus callipygus and the blue duiker Philantomba monticola). In addition, we detected RVFV-specific antibodies in small domestic ruminants (sheep and goats) at an overall antibody prevalence of 15.4%, with a much higher seroprevalence rate in goats than sheep (20.1% versus 3.3%). Furthermore, RVFV-specific antibodies were also observed in a single (hunting) dog out of the 26 tested. These results stress the need to develop adequate surveillance plan measures to better control the public health threat of RVFV. [ABSTRACT FROM AUTHOR]

During the Nigerian Civil War, France became the main supplier of military assistance to the secessionist Biafra. In a neo-imperial pursuit to weaken the potential regional hegemon Nigeria, it secretly provided arms and ammunition to the Biafrans in collusion with Côte d'Ivoire and Gabon. Yet the driving force behind this Franco-African arms triangle was not the Elysée, but the Ivorian president Félix Houphouët-Boigny. Newly unearthed documentary evidence from French archives enables this article to break new historiographical ground: firstly, to show the Elysée's sheer reluctance to militarily assist Biafra and lack of a coherent policy in doing so; secondly, to confirm Houphouët-Boigny as the "mastermind" behind the arming of Biafra, as well as to identify his Cold War motivations; thirdly, to uncover Gabonese president Omar Bongo's increasing agency and influence in the scheme; fourthly, to demonstrate that it was the Ivorian and Gabonese presidents who transformed the arms triangle into a square by bringing the Rhodesians and, especially, the South Africans in; and, finally, to retrace the emergence and functioning of the "African-French" military assistance to Biafra at the policy level not only from Paris's, but also Abidjan's and Libreville's perspectives. [ABSTRACT FROM AUTHOR]

Feeding by Critically Endangered forest elephants Loxodonta cyclotis in rural plantations is a conservation issue in Gabon, but studies characterizing drivers of spatiotemporal patterns of human–elephant interactions remain sparse, hindering mitigation. In this study, we use GPS tracking data from two elephants to characterize temporal patterns of village visitation, and surveys of 101 local farmers across seven villages to determine local patterns of crop planting and harvesting and of human–elephant interactions. Local farmers' perceptions of elephant visitations and empirical data on such visits were positively correlated with local crop availability. However, considering the two elephants separately revealed that the correlations were driven by just one individual, with the second elephant showing weak links between crop availability and visitation, highlighting the challenges in reliably predicting human–wildlife interactions. The most popular local perceptions of the drivers of elephant visitation were the presence of crops (53% of responses) and logging (39%). The most popular proposed interventions were letting the government find a solution (32%), killing problem elephants (30%) and providing compensation for lost crops (22%). We discuss the potential feasibility and efficacy of the proposed solutions in the context of human–elephant interactions. Future research efforts should focus on collaring elephants in zones with high potential for negative human–elephant interaction and expanding perception surveys to villages with contrasting ecological contexts (e.g. with and without logging in their surrounding forests), as these could influence local perceptions of conflicts and conservation initiatives. [ABSTRACT FROM AUTHOR]

Background: Anemia remains a significant public health concern in Gabon, particularly among children, adolescents, and females. Gabon is also home to two major species of filarial worms, Loa and Mansonella spp., which cause microfilaremia. The epidemiological nexus between hemoglobin (Hb) concentrations and microfilaremia in Gabonese firsttime blood donors remains unknown. Aims: To understand better the epidemiological relationship between anemia and microfilaremia to improve donor selection and management protocols. Study Design: A retrospective cohort study. Methods: This study was conducted among first-time blood donors in Lambaréné between March 2018 and October 2019. Participants aged 16-65 years old and weighing a minimum of 50 kg were enrolled using standard donor selection criteria. An automatic hematological analyzer was used to quantify Hb concentrations, and microscopy techniques were used to detect the presence of microfilariae. Results: Microfilariae were found in 4.8% (35/723) of the 723 first-time blood donors from Lambaréné. Anemia was classified as mild in 35.5% (257/723) and moderate in 1% (7/723). No significant associations were found between the distribution of microfilariae and variables such as age, sex, socioprofessional classification, marital status, or residence. Blood group O donors had a higher prevalence of microfilariae (6%) than non-O donors (2.7%). However, the observed difference was not statistically significant (AOR =2.3, p = 0.052). Furthermore, microfilariae were associated with increased moderate anemia (3.7% vs. 29%, AOR =15.6, p = 0.003). Conclusion: Our findings highlight microfilaremia as a possible etiological cause of anemia among Gabonese blood donors, emphasizing the need for further research and a potential review of donor management strategies. [ABSTRACT FROM AUTHOR]

Introduction: Schistosomiasis is a significant public health concern, especially in Sub-Saharan Africa. Conventional microscopy is the standard diagnostic method in resource-limited settings, but with limitations, such as the need for expert microscopists. An automated digital microscope with artificial intelligence (Schistoscope), offers a potential solution. This field study aimed to validate the diagnostic performance of the Schistoscope for detecting and quantifying Schistosoma haematobium eggs in urine compared to conventional microscopy and to a composite reference standard (CRS) consisting of real-time PCR and the up-converting particle (UCP) lateral flow (LF) test for the detection of schistosome circulating anodic antigen (CAA). Methods: Based on a non-inferiority concept, the Schistoscope was evaluated in two parts: study A, consisting of 339 freshly collected urine samples and study B, consisting of 798 fresh urine samples that were also banked as slides for analysis with the Schistoscope. In both studies, the Schistoscope, conventional microscopy, real-time PCR and UCP-LF CAA were performed and samples with all the diagnostic test results were included in the analysis. All diagnostic procedures were performed in a laboratory located in a rural area of Gabon, endemic for S. haematobium. Results: In study A and B, the Schistoscope demonstrated a sensitivity of 83.1% and 96.3% compared to conventional microscopy, and 62.9% and 78.0% compared to the CRS. The sensitivity of conventional microscopy in study A and B compared to the CRS was 61.9% and 75.2%, respectively, comparable to the Schistoscope. The specificity of the Schistoscope in study A (78.8%) was significantly lower than that of conventional microscopy (96.4%) based on the CRS but comparable in study B (90.9% and 98.0%, respectively). Conclusion: Overall, the performance of the Schistoscope was non-inferior to conventional microscopy with a comparable sensitivity, although the specificity varied. The Schistoscope shows promising diagnostic accuracy, particularly for samples with moderate to higher infection intensities as well as for banked sample slides, highlighting the potential for retrospective analysis in resource-limited settings. Trial registration: NCT04505046 ClinicalTrials.gov. Author summary: Assessment of schistosomiasis control programs is a crucial step to understanding the success rate of these control programs. The Schistoscope: an AI-powered automated digital microscope could overcome the limitations of conventional microscopy in endemic resource limited settings as well as in settings lacking microscopy experts. In this study, we carried out an extensive validation of the Schistoscope's diagnostic performance for diagnosis of urogenital schistosomiasis compared to conventional microscopy as well as more accurate diagnostic tests such as real-time PCR and the up-converting particle (UCP) lateral flow (LF) test for the detection of circulating anodic antigen (CAA) on freshly collected urines. We also assessed the performance of the Schistoscope for the diagnosis of schistosomiasis on banked sample slides, using a simple and sustainable storage method, for approximately two years. Having a tool that can prospectively and retrospectively analyse samples in an easy and sustainable way could facilitate schistosomiasis control programs in settings with little or no access to microscopists. Overall, we found the Schistoscope to be as good as conventional microscopy for the diagnosis of schistosomiasis, and given its downstream advantages of digital health, it would serve as a valuable diagnostic/screening tool in resource limited endemic settings. [ABSTRACT FROM AUTHOR]

Background: Gabon still bears significant malaria burden despite numerous efforts. To reduce this burden, policy-makers need strategies to design effective interventions. Besides, malaria distribution is well known to be related to the meteorological conditions. In Gabon, there is limited knowledge of the spatio-temporal effect or the environmental factors on this distribution. This study aimed to investigate on the spatio-temporal effects and environmental factors on the distribution of malaria prevalence among children 2–10 years of age in Gabon. Methods: The study used cross-sectional data from the Demographic Health Survey (DHS) carried out in 2000, 2005, 2010, and 2015. The malaria prevalence was obtained by considering the weighting scheme and using the space–time smoothing model. Spatial autocorrelation was inferred using the Moran's I index, and hotspots were identified with the local statistic Getis-Ord General Gi. For the effect of covariates on the prevalence, several spatial methods implemented in the Integrated Nested Laplace Approximation (INLA) approach using Stochastic Partial Differential Equations (SPDE) were compared. Results: The study considered 336 clusters, with 153 (46%) in rural and 183 (54%) in urban areas. The prevalence was highest in the Estuaire province in 2000, reaching 46%. It decreased until 2010, exhibiting strong spatial correlation (P < 0.001), decreasing slowly with distance. Hotspots were identified in north-western and western Gabon. Using the Spatial Durbin Error Model (SDEM), the relationship between the prevalence and insecticide-treated bed nets (ITNs) coverage was decreasing after 20% of coverage. The prevalence in a cluster decreased significantly with the increase per percentage of ITNs coverage in the nearby clusters, and per degree Celsius of day land surface temperature in the same cluster. It slightly increased with the number of wet days and mean temperature per month in neighbouring clusters. Conclusions: In summary, this study showed evidence of strong spatial effect influencing malaria prevalence in household clusters. Increasing ITN coverage by 20% and prioritizing hotspots are essential policy recommendations. The effects of environmental factors should be considered, and collaboration with the national meteorological department (DGM) for early warning systems is needed. [ABSTRACT FROM AUTHOR]

Background: Strengthening the surveillance of zoonotic diseases emergence in the wild meat value chains is a critical component of the prevention of future health crises. Community hunters could act as first-line observers in zoonotic pathogens surveillance systems in wildlife, by reporting early signs of the possible presence of a disease in the game animals they observe and manipulate on a regular basis. Methods: An experimental game was developed and implemented in a forested area of Gabon, in central Africa. Our objective was to improve our understanding of community hunters' decision-making when finding signs of zoonotic diseases in game animals: would they report or dissimulate these findings to a health agency? 88 hunters, divided into 9 groups of 5 to 13 participants, participated in the game, which was run over 21 rounds. In each round the players participated in a simulated hunting trip during which they had a chance of capturing a wild animal displaying clinical signs of a zoonotic disease. When signs were visible, players had to decide whether to sell/consume the animal or to report it. The last option implied a lowered revenue from the hunt but an increased probability of early detection of zoonotic diseases with benefits for the entire group of hunters. Results: The results showed that false alerts—i.e. a suspect case not caused by a zoonotic disease—led to a decrease in the number of reports in the next round (Odds Ratio [OR]: 0.46, 95% Confidence Interval [CI]: 0.36–0.8, p < 0.01). Hunters who had an agricultural activity in addition to hunting reported suspect cases more often than others (OR: 2.05, 95% CI: 1.09–3.88, p < 0.03). The number of suspect case reports increased with the rank of the game round (Incremental OR: 1.11, CI: 1.06–1.17, p < 0.01) suggesting an increase in participants' inclination to report throughout the game. Conclusion: Using experimental games presents an added value for improving the understanding of people's decisions to participate in health surveillance systems. [ABSTRACT FROM AUTHOR]

We detected a novel GII.4 variant with an amino acid insertion at the start of epitope A in viral protein 1 of noroviruses from the United States, Gabon, South Africa, and the United Kingdom collected during 2017-2022. Early identification of GII.4 variants is crucial for assessing pandemic potential and informing vaccine development. [ABSTRACT FROM AUTHOR]

Background: Soil-transmitted helminth (STH) infections are a public health concern in endemic areas. For efficient control, the epidemiology of the disease needs to be monitored. This report assesses the prevalence, incidence, post-treatment infection (PTI) rate, and risk factors for STH infections in two rural areas of Gabon. Method: In this longitudinal and prospective study, participants aged six to 30 years from the vicinity of Lambaréné and selected households using a simple randomization process were included and followed in two consecutive periods of six and nine months. Stool samples were obtained at the beginning and the end of each follow-up phase (FUP). The Kato-Katz technique was used for the detection of STH eggs, while the Harada-Mori technique and coproculture were used for the detection of larvae in stool processed within a maximum of four hours of collection. Prevalence was determined at the three main time points of the study, incidence was assessed during the two study phases, and PTI was defined as an infection detected nine months post-treatment. Results: A total of 262 participants were included. The overall prevalence of STH infections was 42% (95%CI: 34–50) and 44% (95%CI: 37–51) at baseline for the six and nine month FUPs, respectively. Trichuris trichiura was the most prevalent species at each time point of assessment. The cumulative incidence of STH at the 6- and 9-month follow-ups was 18% (95%CI: 12–27) and 35% (95%CI: 27–43), respectively, while the incidence rates were 41 (95%CI: 28–55) and 56 (95%CI: 46–67) per 100 person-years, respectively. The PTI rates at the 9-month follow-up for T. trichiura, hookworm, and Ascaris lumbricoides were 58% (95%CI: 41–74), 31% (95%CI: 11–59) and 18% (95%CI: 5–40), respectively. The STH infection intensity was generally light. Conclusion: The prevalence level of STH infection is moderate in the vicinity of Lambaréné, with T. trichiura being the most prevalent species. Our results reveal a rapid spread of the disease in the population mainly following intervention, particularly for trichuriasis, and therefore call for the full implementation of the World Health Organization's recommendations in the area. Trial registration clinicaltrials.gov Identifier NCT02769013. Registered 21 April 2016, https://clinicaltrials.gov/study/NCT02769013 [ABSTRACT FROM AUTHOR]

Introduction: birth weight is a critical indicator of neonatal health and predicts future developmental outcomes. Despite its importance, there is a notable lack of research on the determinants of low birth weight (LBW) in southeast Gabon. This study aims to fill this gap by identifying factors contributing to LBW at the Centre Hospitalier Universitaire Amissa Bongo in Franceville. Methods: this retrospective analysis covered the period from February 2011 to May 2017, focusing on postpartum women and their infants. Data were analyzed using R software (version 4.3.2), employing both descriptive statistics and logistic regression. Statistical significance was determined at a p-value of less than 0.05. Results: among the 877 births analyzed, the prevalence of LBW was 8.4%. Bivariate analysis identified several factors associated with an increased risk of LBW, including, primigravida women (COR (95%CI) =0.59 (0.36-0.98), P = 0.036), primiparous women (COR (95%CI) =0.58 (0.36-0. 94), P = 0.024), women with a gestational age <37 weeks (COR (95%CI) =0.07 (0.04-0.11), P<0.001), women with =2 antenatal visits (COR (95%CI) =0.39 (0.18-0.93), P= 0.021), and women who underwent cesarean delivery (COR (95%CI) =0.46 (0.26-0.84), P = 0.008). However, multivariate analysis showed that only gestational age (AOR (95%CI) = 0.07 (0.04-0.11), P<0.001) and cesarean delivery (AOR (95%CI) = 0.48 (0.25-0.95), P = 0.03) were significantly associated with LBW. Conclusion: this study highlights the importance of gestational age and delivery method in the prevalence of LBW in southeast Gabon. These findings underscore the need for targeted interventions to address these risk factors, thereby improving neonatal health outcomes. [ABSTRACT FROM AUTHOR]

The hallucinogenic plant Tabernanthe iboga is used as a source of visions by various ethnic groups of western equatorial Africa in the context of a complex system of religious, therapeutic and divinatory practices that can collectively be defined as 'iboga cults'. The most renowned are the religious cults known as Bwiti. The author presents a series of studies on the iboga cults, based on field investigations in Gabon undertaken in the period 1991-2022. In this first article, the first written documents attesting to the traditional use of iboga are presented and discussed. At the current state of research, the oldest reference to the existence of Bwiti is dated to 1861, while the oldest reference to iboga is dated to 1862. 1862 is also the first date of the arrival of this plant in Europe. Inconsistencies in the translation of ancient texts from the original English to the French are highlighted, which have generally escaped French-speaking scholars and which also concern the first quotations of Bwiti. [ABSTRACT FROM AUTHOR]

The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) is still one of the main causes of death in sub-Saharan Africa. Antiretroviral therapies (ARTs) have significantly improved the health conditions of people living with HIV/AIDS (PLWHA). Consequently, a significant drop in morbidity and mortality, along with a reduced incidence of opportunistic infections (OIs), has been observed. However, certain atypical and biological profiles emerge in ART patients post-examination. The objective of this study was to identify the risk factors that contributed to the onset of OIs in HIV patients undergoing ART in Gabon. Epidemiological and biological data were obtained from medical records (2017 to 2019) found at the outpatient treatment centre (CTA) of Franceville in Gabon. Samples for blood count, CD4, and viral load analysis at CIRMF were collected from PLWHA suffering from other pathogen-induced conditions. A survey was carried out and data were analysed using Rstudio 4.0.2 and Excel 2007 software. Biological and socio-demographic characteristics were examined concerning OIs through both a univariate analysis via Fisher's exact tests or chi2 (χ2), and a multivariate analysis via logistic regression. Out of the 300 participants initially selected, 223 were included in the study, including 154 (69.05%) women and 69 (30.95%) men. The mean age was 40 (38.6; 41.85), with individuals ranging from 2 to 77 years old. The study cohort was classified into five age groups (2 to 12, 20 to 29, 30 to 39, 40 to 49, and 50 to 77 years old), among which the groups aged 30 to 39 and 40 to 49 emerged as the largest, comprising 68 (30.5%) and 75 (33.6%) participants, respectively. It was noted that 57.9% of PLWHA had developed OIs and three subgroups were distinguished, with parasitic, viral, and bacterial infections present in 18%, 39.7%, and 55.4% of cases, respectively. There was a correlation between being male and having a low CD4 T-cell count and the onset of OIs. The study revealed a high overall prevalence of OIs, and extending the study to other regions of Gabon would yield a better understanding of the risk factors associated with the onset of these infections. [ABSTRACT FROM AUTHOR]

Uranium from Africa was, and remains, a major source of fuel for atomic weapons and power plants throughout the world. Uranium for the Hiroshima bomb, for example, came from the Belgian Congo. During any given year of the Cold War, between 20 percent and 50 percent of the Western world's uranium came from African places: Congo, Niger, South Africa, Gabon, Madagascar, and Namibia. Today, there is a renewed uranium boom throughout the continent. The author writes on the ambiguities of the nuclear state, and the state of being nuclear, and why the nuclear designation matters. She looks at two countries to uncover different dimensions of nuclearity: Niger, which has long struggled with France over the price of its uranium; and Gabon, where cancer and other illnesses related to four decades of uranium production remain invisible. [ABSTRACT FROM AUTHOR]

Background: Pyrethroids are the main insecticides used in vector control for malaria. However, their extensive use in the impregnation of long-lasting insecticidal nets (LLINs) and indoor residual spraying has led to the development of resistance, threatening its success as a tool for malaria control. Baseline data prior to large scale distribution of LLINs are important for the implementation of efficient strategies. However, no data on the susceptibility of malaria vectors is available in the Moyen-Ogooué Province in Gabon. The aim of this study was to assess the susceptibility to pyrethroids and organochlorides of malaria vectors from a semi-urban and rural areas of the province and to determine the frequency of insecticide resistance genes. Methods: Larvae were collected from breeding sites in Lambaréné and Zilé and reared to adults. Three to five-day old female Anopheles gambiae sensu lato mosquitoes were used in cone tube assays following the WHO susceptibility tests protocol for adult mosquitoes. A subsample was molecularly identified using the SINE200 protocol and the frequency of Vgsc-1014 F and − 1014 S mutations were determined. Results: Anopheles gambiae sensu stricto (s.s.) was the sole species present in both Lambaréné and Zilé. Mosquito populations from the two areas were resistant to pyrethroids and organochlorides. Resistance was more pronounced for permethrin and DDT with mortality lower than 7% for both insecticides in the two study areas. Mosquitoes were statistically more resistant (P < 0.0001) to deltamethrin in Lambaréné (51%) compared to Zilé (76%). All the mosquitoes tested were heterozygous or homozygous for the knockdown resistance (Kdr) mutations Vgsc-L1014F and Vgsc-L1014S with a higher proportion of Vgsc-L1014F homozygous in Lambaréné (76.7%) compared to Zilé (57.1%). Conclusion: This study provides evidence of widespread resistance to pyrethroids in An. gambiae s.s., the main malaria vector in the Moyen-Ogooué Province. Further investigation of the mechanisms underlining the resistance of An. gambiae s.s. to pyrethroids is needed to implement appropriate insecticide resistance management strategies. [ABSTRACT FROM AUTHOR]

The place of local products in out-of-home catering and the growth of non-communicable metabolic diseases in sub-Saharan Africa raise questions. To identify the influence of the economic and social environments on this phenomenon, this study analyzes the foods and consumers concerning the main meal of the day. A survey of 180 customers from seventy-three catering establishments in the province of Haut Ogooué in southeastern Gabon was conducted. They were interviewed between 11 a.m. and 6 p.m. over a month using a semi-structured questionnaire providing socio-demographic variables, foods, side dishes, cooking methods, prices, and food additives consumed in restaurants and at home. The results show that clients are disadvantaged young people (30.3 ± 9.7 years) who consume animal proteins that are less available at home. Low prices, imported food, proximity, the availability of food additives rich in oils and salts, and the possibility of consuming local side foods explain the success of out-of-home catering. The cooking and consumption patterns are conducive to the development in the long-term of non-communicable metabolic diseases. [ABSTRACT FROM AUTHOR]